Bus Fumes and Cigarettes

This is an excerpt from my upcoming memoir. It starts on my fourth day in a psychiatric ward, after being sectioned for the first time. I had been sectioned for not eating and was barely drinking anything. In these four days in hospital, I had had one cup of water on day three but no food. I was starving and dehydrating myself because of threats to my family made by one of my voices, who called himself the devil.

I was prescribed olanzapine (also known as Zyprexa) but I refused to take it, as I believed that I was mentally well. The ward I was in was an upstairs ward, meaning that there were no gardens attached to the ward; the only means to the outside world were by leaving the ward.

I had been having blood tests each day and this fourth day was no exception. This morning’s results were brought in to me and two levels were highlighted as being dangerous. I’ve no idea what these levels were but the nurses told me that if I didn’t eat or drink anything soon I would die. At that point I didn’t really care. The devil was telling me that I had drank poison the previous day in the cup of water I had had and if I steered clear of liquids for a few more days, I would recover. I believed the devil, and the nurses could see they were fighting a losing battle.

After the nurses had failed in their attempt to scare me into eating and drinking, they walked away. I looked out of the window and saw normality going by. I longed to be down there, walking free and enjoying the fresh air. The more I thought about being in the fresh air, the more the air in the ward felt stale and contaminated. I thought that there were poisons in the air and the devil started agreeing with these thoughts. I panicked, and tried to open the window to get some fresh air. It only opened a small way, barely enough to get my fingers through the gap never mind my head.

I started feeling extremely claustrophobic and thought if I didn’t get outside for some fresh air, I would suffocate. I asked to be allowed outside but was refused, as I didn’t have any leave. I pleaded with them to have five minutes of fresh air but was told no. They brought in the psychiatrist who had been allocated to me, and I begged him to let me go outside for two minutes. He shook his head saying that he couldn’t allow it as I might faint on the stairs. I pointed out that there was a lift a few footsteps away from the door of the ward but he still refused.

He then made me an offer that if I ate and drank proper meals for the next couple of days, he would think about letting me go outside for a few minutes. I had an hour to eat and drink something and if I didn’t, he would have to start looking into alternative treatments. I had no idea what that meant but it didn’t solve my immediate problem. As a result, I didn’t eat or drink anything.

When the psychiatrist saw me an hour later, he said he would have to look at alternative treatments. I didn’t care; I had been obeying the devil so he wasn’t shouting at me at least. He offered me half a lorazepam (a sedative also known as Ativan), which he said would help with my panic. I had resigned myself to my fate of suffocating in the ward and thought that a sedative would maybe help me to fall unconscious and not feel the slow death. I accepted the lorazepam to the shock of the staff and waited for it to take effect.

While the drug started to take effect, I started thinking how much better it would be to have been a smoker. There were patients in all mental states, some on sections, some not, who were allowed outside a minimum of once a day to have a cigarette. Meanwhile, I had been festering inside for four days, not allowed access to fresh air. There were even patients who made escape attempts who were allowed outside for cigarettes again the following day, while I was locked inside, punishment it seemed for being a non-smoker.

The drug did have some effect a while later and did calm me down enough that I was able to breathe properly again. The psychiatrist saw me after it had taken effect and told me that he was looking into ECT (Electroconvulsive Therapy). I had no idea what that was but guessed that it was electric shock therapy. I didn’t realise that it was still being done and was a bit scared at this thought. I told him that I didn’t want it but he said that I didn’t have a choice. They would be able to do it without my permission.

That information really scared me. I did consider eating and drinking something to avoid it but the devil threateningly told me that if I did, he would kill my family. He told me to stop being selfish and thinking of myself, I had to think of my family. Did I want them to die because I was selfish? When the psychiatrist had finished telling me about ECT, I walked back to my bed feeling really scared. I still refused lunch and dinner though.

That night, after refusing the olanzapine for a fourth night, a doctor was called to speak to me. I had been given no information about olanzapine up to this point, apart from the fact that it was an antipsychotic. When I asked the nurses about it, they told me to speak to a doctor. When I asked doctors about it, they told me the nurses would give me information about it. Not helpful. I held out my refusal to take olanzapine and ended up being restrained and injected in a highly unprofessional and humiliating manner.

The following morning, I woke to a blurry world. Everything looked and felt weird. Even walking felt like a foreign activity. When I was offered meds, I accepted them out of fear. The tablet dissolved in my mouth, which admittedly disappointed me. I had been hoping to hide the tablet under my tongue and then spit it out. However, the dissolving tablet was a blessing in disguise. Even though it dissolved, the nurses still checked my mouth and under my tongue.

I was offered a bottle of Ensure Plus that morning and despite the devil warning me not to accept it, I drank it. Ensure Plus is a nutritional drink designed to prevent malnutrition. I was too scared not to drink it in case that too was somehow forced into me. Despite the horrible taste, it did make me feel slightly better physically. I hadn’t had any form of nourishment for two and a half weeks and had had about 200 ml of water in the previous four days.

Before long, I was used to my routine of four Ensure drinks a day with 5 mg of olanzapine in the morning and at night. I was coerced into taking sertraline shortly afterwards and was taking 200 mg within three weeks. I was also frequently woken from a nap with a large glass of orange juice. I hated when this happened as I’ve never really liked the taste of orange juice and it’s notorious for giving me headaches but I was too scared to refuse anything. I was having frequent headaches and migraines at this point and I didn’t want anything exacerbating them. However, the fear of humiliation made me drink it without complaint.

On my ninth day on the ward, a healthcare assistant saw that I wasn't allowed to go outside and asked me why. I told her that the doctors wouldn't let me because they said I would faint if I went down the stairs. The healthcare assistant gave me a look that said, 'That's stupid!' and told me to leave it with her. A short while later, she came to my bed area and told me she was taking me outside.

Not wanting to look a gift horse in the mouth, I jumped up off my bed and followed her outside. The air was thick with cigarette smoke and what smelt like bus fumes, but in reality, it was probably fumes from an ambulance or delivery van. Despite the air probably being far more toxic than the air on the ward, my first fresh air in nine days felt amazing. For a few brief moments, I felt normal again and could almost taste the ‘fresh’ air in my mouth!

I stood at the entrance to the unit for about 10 minutes talking to the healthcare assistant. After 10 minutes of feeling human again, she took me back upstairs. I felt a lot happier, but not quite happy. She got one of the student nurses to take me outside again that afternoon and I spent another 10 or so minutes with a half smile on my face. I was met with the aroma of the ‘bus’ fumes and cigarettes again, but it didn’t matter. Bus fumes and cigarettes were the smell of freedom.

I only saw the healthcare assistant a couple more times after this but I've never forgotten her kindness or common sense. I really think she stopped me from going completely insane.

My memoir will hopefully be published in the near future.